Virseda-Berdices Ana, Behar-Lagares Raquel, Martínez-González Oscar, Blancas Rafael, Bueno-Bustos Soraya, Brochado-Kith Oscar, Manteiga Eva, Mallol Poyato María J, López Matamala Blanca, Martín Parra Carmen, Resino Salvador, Jiménez-Sousa María Á, Fernández-Rodríguez Amanda
Unit of Viral Infection and Immunity, National Center for Microbiology (CNM), Health Institute Carlos III (ISCIII), Majadahonda, Madrid, Spain.
Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
Crit Care. 2024 Aug 7;28(1):267. doi: 10.1186/s13054-024-05051-6.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes virus-induced-senescence. There is an association between shorter telomere length (TL) in coronavirus disease 2019 (COVID-19) patients and hospitalization, severity, or even death. However, it remains unknown whether virus-induced-senescence is reversible. We aim to evaluate the dynamics of TL in COVID-19 patients 1 year after recovery from intensive care units (ICU). Longitudinal study enrolling 49 patients admitted to ICU due to COVID-19 (August 2020 to April 2021). Relative telomere length (RTL) quantification was carried out in whole blood by monochromatic multiplex real-time quantitative PCR (MMqPCR) assay at hospitalization (baseline) and 1 year after discharge (1-year visit). The association between RTL and ICU length of stay (LOS), invasive mechanical ventilation (IMV), prone position, and pulmonary fibrosis development at 1-year visit was evaluated. The median age was 60 years, 71.4% were males, median ICU-LOS was 12 days, 73.5% required IMV, and 38.8% required a prone position. Patients with longer ICU-LOS or who required IMV showed greater RTL shortening during follow-up. Patients who required pronation had a greater RTL shortening during follow-up. IMV patients who developed pulmonary fibrosis showed greater RTL reduction and shorter RTL at the 1-year visit. Patients with longer ICU-LOS and those who required IMV had a shorter RTL in peripheral blood, as observed 1 year after hospital discharge. Additionally, patients who required IMV and developed pulmonary fibrosis had greater telomere shortening, showing shorter telomeres at the 1-year visit. These patients may be more prone to develop cellular senescence and lung-related complications; therefore, closer monitoring may be needed.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）可导致病毒诱导的衰老。2019冠状病毒病（COVID-19）患者的端粒长度（TL）较短与住院、病情严重程度甚至死亡之间存在关联。然而，病毒诱导的衰老是否可逆仍不清楚。我们旨在评估COVID-19患者从重症监护病房（ICU）康复1年后TL的动态变化。对49例因COVID-19入住ICU的患者（2020年8月至2021年4月）进行纵向研究。在住院时（基线）和出院1年后（1年随访），通过单色多重实时定量PCR（MMqPCR）检测对全血中的相对端粒长度（RTL）进行定量。评估了RTL与ICU住院时间（LOS）、有创机械通气（IMV）、俯卧位以及1年随访时肺纤维化发展之间的关联。中位年龄为60岁，71.4%为男性，中位ICU-LOS为12天，73.5%需要IMV，38.8%需要俯卧位。ICU-LOS较长或需要IMV的患者在随访期间RTL缩短更明显。需要俯卧位的患者在随访期间RTL缩短更明显。发生肺纤维化的IMV患者在1年随访时RTL降低更明显且RTL更短。出院1年后观察到，ICU-LOS较长的患者和需要IMV的患者外周血RTL较短。此外，需要IMV且发生肺纤维化的患者端粒缩短更明显，在1年随访时端粒更短。这些患者可能更容易发生细胞衰老和肺部相关并发症；因此，可能需要更密切的监测。
